tetano
Editor, Senior Moderator
Pediatr Infect Dis J
. 2023 Sep 15.
doi: 10.1097/INF.0000000000004110. Online ahead of print. Clinical Course, Therapeutic Management and Outcome of Coronavirus Disease in Patients With Inborn Errors of Immunity: A Retrospective Multicenter Experience From Iran
Abdollah Karimi[SUP] 1 [/SUP], Mahnaz Jamee[SUP] 2 3 [/SUP], Youssef Shokri[SUP] 4 5 [/SUP], Atefeh Heidari[SUP] 3 [/SUP], Fatemeh Nazarpack[SUP] 3 [/SUP], Mazdak Fallahi[SUP] 3 [/SUP], Reza Shiari[SUP] 6 [/SUP], Philip H Li[SUP] 7 [/SUP], Niusha Sharifinejad[SUP] 8 [/SUP], Samin Sharafian[SUP] 3 [/SUP], Seyed Alireza Mahdaviani[SUP] 9 [/SUP], Davood Mansouri[SUP] 9 [/SUP], Amirreza Zeinali[SUP] 10 [/SUP], Soheila Alyasin[SUP] 4 5 [/SUP], Zahra Chavoshzadeh[SUP] 3 [/SUP]; Study Group
Collaborators, Affiliations
Background: Inborn errors of immunity (IEIs) are characterized by defects in the structure and function of the immune system. This study was designed to assess the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on this potentially particularly susceptible group of patients.
Methods: This retrospective cross-sectional study analyzed patients from 3 referral immunodeficiency centers in Iran. The demographic, clinical, laboratory and therapeutical data of confirmed IEI patients with SARS-CoV-2 infection were collected and analyzed.
Results: A total of 19 IEI patients, 52.6% male and 47.4% female, with coronavirus disease 2019 (COVID-19) were enrolled. The most common diagnosed IEIs were (severe) combined immunodeficiency ((S)CID) (9, 47.4%) and predominantly antibody deficiencies (7, 36.8%). The main presenting symptoms included fever (16, 84.2%), cough (12, 63.2%), dyspnea (9, 47.4%) and myalgia (8, 42.1%). Among additional preexisting comorbidities, atopy (P = 0.087) and renal disorders (P = 0.087) were more strongly associated with the development of respiratory failure, although not statistically significant. SARS-CoV-2 infection was determined by polymerase chain reaction (n = 19, 100%) within a median (interquartile range) of 1 (0-6) days following admission. Among all laboratory indices, thrombocytopenia (P = 0.009) was associated with a need for intensive care unit admission. The overall mortality rate was 36.9% and highest among (S)CID patients (4, 44.4%).
Conclusions: Severe COVID-19 most frequently affected (S)CID and predominantly antibody deficiencies patients among this multicenter Iranian cohort. Further studies are required to evaluate the impact of additional preexisting comorbidities and the development of thrombocytopenia on the severity and prognosis of COVID-19 in IEIs.
. 2023 Sep 15.
doi: 10.1097/INF.0000000000004110. Online ahead of print. Clinical Course, Therapeutic Management and Outcome of Coronavirus Disease in Patients With Inborn Errors of Immunity: A Retrospective Multicenter Experience From Iran
Abdollah Karimi[SUP] 1 [/SUP], Mahnaz Jamee[SUP] 2 3 [/SUP], Youssef Shokri[SUP] 4 5 [/SUP], Atefeh Heidari[SUP] 3 [/SUP], Fatemeh Nazarpack[SUP] 3 [/SUP], Mazdak Fallahi[SUP] 3 [/SUP], Reza Shiari[SUP] 6 [/SUP], Philip H Li[SUP] 7 [/SUP], Niusha Sharifinejad[SUP] 8 [/SUP], Samin Sharafian[SUP] 3 [/SUP], Seyed Alireza Mahdaviani[SUP] 9 [/SUP], Davood Mansouri[SUP] 9 [/SUP], Amirreza Zeinali[SUP] 10 [/SUP], Soheila Alyasin[SUP] 4 5 [/SUP], Zahra Chavoshzadeh[SUP] 3 [/SUP]; Study Group
Collaborators, Affiliations
- PMID: 37751625
- DOI: 10.1097/INF.0000000000004110
Background: Inborn errors of immunity (IEIs) are characterized by defects in the structure and function of the immune system. This study was designed to assess the impact of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection on this potentially particularly susceptible group of patients.
Methods: This retrospective cross-sectional study analyzed patients from 3 referral immunodeficiency centers in Iran. The demographic, clinical, laboratory and therapeutical data of confirmed IEI patients with SARS-CoV-2 infection were collected and analyzed.
Results: A total of 19 IEI patients, 52.6% male and 47.4% female, with coronavirus disease 2019 (COVID-19) were enrolled. The most common diagnosed IEIs were (severe) combined immunodeficiency ((S)CID) (9, 47.4%) and predominantly antibody deficiencies (7, 36.8%). The main presenting symptoms included fever (16, 84.2%), cough (12, 63.2%), dyspnea (9, 47.4%) and myalgia (8, 42.1%). Among additional preexisting comorbidities, atopy (P = 0.087) and renal disorders (P = 0.087) were more strongly associated with the development of respiratory failure, although not statistically significant. SARS-CoV-2 infection was determined by polymerase chain reaction (n = 19, 100%) within a median (interquartile range) of 1 (0-6) days following admission. Among all laboratory indices, thrombocytopenia (P = 0.009) was associated with a need for intensive care unit admission. The overall mortality rate was 36.9% and highest among (S)CID patients (4, 44.4%).
Conclusions: Severe COVID-19 most frequently affected (S)CID and predominantly antibody deficiencies patients among this multicenter Iranian cohort. Further studies are required to evaluate the impact of additional preexisting comorbidities and the development of thrombocytopenia on the severity and prognosis of COVID-19 in IEIs.